Carotid Artery Stent Operations Carry Fourfold Risk of Stroke, Death At Some Hospitals: Study

New research suggests that individuals undergoing carotid artery stenting may face an increased risk of death or stroke, yet the risk may vary widely among different U.S. hospitals. 

In the May issue of the Journal of the American College of Cardiology, researchers indicate that the risk of stroke and death after undergoing carotid artery stent (CAS) surgery may be up to four times higher at certain hospitals, and suggested that the variance in problems highlights a need for more research to improve patient outcomes.

The study focused on data from 188 different hospitals across the U.S., which were participating in the National Cardiovascular Data Registry-Carotid Artery Endarterectomy and Revascularization Registry.

More than 19,000 carotid artery stenting (CAS) procedures were conducted at the hospitals between 2005 to 2013. Each hospital had to contribute more than five carotid artery stenting procedures during the eight year period to be eligible for inclusion.

Researchers note that the stroke rates for patients after undergoing carotid artery stenting ranged widely, from zero up to 19% among some U.S. hospitals. Death rates also varied, ranging from one percent to nearly five percent among some medical centers.

The carotid arteries are two large blood vessels in the neck that supply blood to the brain. The arteries can often begin to narrow due to the buildup of fatty substances and cholesterol deposits or artherosclerosis, which may place a patient at higher risk of suffering a stroke.

Carotid artery stenting opens a blocked or narrowed artery and is less invasive than other procedures. Doctors use a small balloon to put in place a mesh stent to keep the artery open, which increases the blood flow to the brain typically preventing future stroke. It is a relatively new procedure, but used widely across the United States in recent years.

Researchers are unsure whether the increased death and stroke rates are due to some hospitals treating sicker patients. The number of procedures performed at a hospital did not effect the rates. Researchers recommend more studies to determine the disparity.

“However, our analyses also suggest that some hospitals are achieving better outcomes than others, and it will be important to identify the reasons for this so that all centers offering this therapy can achieve exceptional outcomes,” said Dr. Beau Hawkins, lead author and cardiologist at the University of Oklahoma Health Sciences Center.